- guardian.co.uk, Tuesday 2 July 2002 02.21 BST
But is it right for overseas organisations to take over "our" local hospital and profit from our illness? How accountable will an overseas hospital be if anything goes wrong? Will the NHS be asked to pick up difficult patients with unforeseen complications? When private hospitals attempt treatment beyond their expertise, they fail and have to be bailed out by the NHS. When the overseas "quick fix" turns into lengthy complications, who will be responsible for the patient who becomes chronically ill?
Dr MI Heatley
Oxford
· While seeking a "routine" cataract operation I felt like a nuisance, to be put off time after time, even when I explained that my work as an architect was at risk because of my failing sight. I discovered other people were queue jumping, despite some being retired. I felt I was being pressured to use Bupa, at a cost of £2,375 per eye, because I am a professional person.
I decided to shop around. I travelled to Germany within a week and had the operation at a leading eye clinic; even including travel the cost was less than half of Bupa's fee and the results were perfect.
The clinic was running at full stretch from 8am on Monday and my surgeon apologised that the morning had been a hectic. On asking how many operations the team had carried out I was told "62". I have reluctantly concluded that, despite some heroic individual health workers, the NHS will never perform efficiently, regardless of spending levels, because of inbuilt negative attitudes and practices.
Chris McGrath
Rye, East Sussex
· The Conservative vision of the NHS led to the development of hospitals as quasi city-states, dominated by a bureaucratic drive to balance the books and characterised by competition, fragmentation and disengagement of senior clinical staff. Morale hit rock bottom, nurses were made redundant, medical schools shorn of students and bed numbers massively reduced. Now, we have a vision that recognises the importance of clinical leadership, that capacity needs to increase to meet demand; more new hospitals are being built than at any other time in the service's history, underpinned by a modernisation agenda that will increase multidisciplinary care.
In my field, cancer care, we have united hospitals into networks which ensure that patients will be treated by the best clinical teams, working with nationally agreed guidelines supported by clinical trials. We probably have the most rapidly improving cancer service in the world. The main outstanding problem is the need to get the new money to the front line by a more direct route. Marks out of 10 - seven; the Tories and will never score more than three.
Prof David Kerr
University of Oxford
david.kerr@clinical-pharmacology.oxford.ac.uk
· Your report that the public health laboratory service has warned of an increase in confirmed cases of measles demonstrates the PHLS's one-dimensional view of child health (Measles cases quadruple, July 1). Ask the PHLS how many suspected or confirmed cases of measles in south London, or wherever, and they will supply an accurate answer. Ask them how many cases of acquired autism there are in the same area and they haven't the slightest idea. Or, apparently, interest. Why does measles count, but not autism?
David Thrower
Warrington, Cheshire
